Intervention material used at Inselspital University Hospital Bern, Switzerland. (A) Avanos Introducer Kit for Gastrostomy Feeding Tube with four SAF-T-PEXY T-Fasteners next to CM (contrast media) and 10 mL Iopamiro 300 diluted with sodium chloride with a ratio 1:2 (Bracoo Suisse SA, Cadempino, Switzerland). Flocare® Gastro Tube CH 14 in the middle. The 0.035” J-tip guidewire is above the gastric tube. The Avanos Enteral Access Dilation System is left to the pink scalpel, and Lidocain 1% is in the bigger syringe. In the other syringe, there is 10 mL sterile water, Aqua ad iniectabilia Bichsel (Large pharmacy Dr. G. Bichsel AG, Interlaken, Switzerland). NaCl = sodium chloride. (B) Schematic illustration of the use of SAF-T-PEXY T-Fastener. (1) Attach a luer slip syringe containing 1–2 mL of sterile water or saline to the needle hub. (2) Insert the preloaded SAF-T-PEXY slotted needle with a single sharp thrust through one of the marked corners of the triangle until it reaches the gastric lumen. The simultaneous return of air into the syringe and visualization confirms the correct placement. (3) Release the suture strand and bend the locking tab on the needle hub. (4) Firmly push the inner hub into the outer hub until the locking mechanism clicks into place. (5) This will release the T-bar from the end of the needle and lock the inner stylet into position. (6) Withdraw the needle while gently pulling the T-bar until it lies flush against the gastric mucosa. Avoid applying excessive tension on the T-bar against the gastric mucosa. Discard the needle following facility protocol [18].